A survey of oral surgeons’ tobacco-use-related knowledgeand intervention behaviors

Objectives: To evaluate whether oral surgeons are aware of tobacco’s role in oral health. Moreover, we wanted to know professionals’ attitudes towards smoker patients and physicians’ involvement in detecting and eradicating this habit in patients.Study Design: We conducted a survey to determine the awareness of the members of the Spanish Society of Oral Surgery about tobacco’s damage on oral health and the role of dentists in the prevention and elimination of the smoking habit. Results: 450 surveys were distributed during the Seventh National Congress of the Spanish Society of Oral Surgery, of which 224 (49.8%) were answered. Seventy-six point eight percent of oral surgeons said that they have a good knowledge of the effects of snuff on oral health. However, only 42.9% admitted they had received specific training regarding how to deal with patients who want to give up smoking. Sixty-three point four percent had explained to smoker patients the risk of this habit for the oral and general health. However, 17% admitted they do not advise their patients to give up smoking for fear of upsetting them, while 15.2% expressed lack of time, and 3.6% think it is not their competence. As to the relationship between oral cancer and smoking, 83% of oral surgeons recognize a direct relationship. In addition, 85.7% of professionals believe that dentists have a primary role in oral cancer prevention. Conclusions: These results indicate that most oral surgeons are concerned about the smoking habit of their patients. However, it is necessary to increase the specific training of dentists by providing tobacco treatment programs as part of their professional responsibility. Oral surgeons recognize the direct relationship between the smoking habit and oral cancer and regard as very important the role of dentists in the prevention of this disease (AU)

A survey of oral surgeons' tobacco-use-related knowledge and intervention behaviors.

OBJECTIVES: To evaluate whether oral surgeons are aware of tobacco' s role in oral health. Moreover, we wanted to know professionals' attitudes towards smoker patients and physicians' involvement in detecting and eradicating this habit in patients. STUDY DESIGN: We conducted a survey to determine the awareness of the members of the Spanish Society of Oral Surgery about tobacco' s damage on oral health and the role of dentists in the prevention and elimination of the smoking habit. RESULTS: 450 surveys were distributed during the Seventh National Congress of the Spanish Society of Oral Surgery, of which 224 (49.8%) were answered. Seventy-six point eight percent of oral surgeons said that they have a good knowledge of the effects of snuff on oral health. However, only 42.9% admitted they had received specific training regarding how to deal with patients who want to give up smoking. Sixty-three point four percent had explained to smoker patients the risk of this habit for the oral and general health. However, 17% admitted they do not advise their patients to give up smoking for fear of upsetting them, while 15.2% expressed lack of time, and 3.6% think it is not their competence. As to the relationship between oral cancer and smoking, 83% of oral surgeons recognize a direct relationship. In addition, 85.7% of professionals believe that dentists have a primary role in oral cancer prevention. CONCLUSIONS: These results indicate that most oral surgeons are concerned about the smoking habit of their patients. However, it is necessary to increase the specific training of dentists by providing tobacco treatment programs as part of their professional responsibility. Oral surgeons recognize the direct relationship between the smoking habit and oral cancer and regard as very important the role of dentists in the prevention of this disease.

Comparative study of two needle models in terms of deflection during inferior alveolar nerve block.

OBJECTIVES: The purpose of this study is to determine the possible differences in deflection between two needles of same length and external gauge but with different internal gauges during truncal block of the inferior alveolar nerve. The initial working hypothesis was that greater deflection may be expected with larger internal gauge needles. STUDY DESIGN: Four clinicians subjected 346 patients to inferior alveolar nerve block and infiltrating anesthesia of the buccal nerve trajectory for the surgical or conventional extraction of the lower third molar. A nonautoaspirating syringe system with 2 types of needle was used: a standard 27-gauge x 35-mm needle with an internal gauge of 0.215 mm or an XL Monoprotect 27-gauge x 35-mm needle with an internal gauge of 0.265 mm. The following information was systematically recorded for each patient: needle type, gender, anesthetic technique (direct or indirect truncal block) and the number of bone contacts during the procedure, the patient-extraction side, the practitioner performing the technique, and blood aspiration (either positive or negative). RESULTS: 346 needles were used in total. 190 were standard needles (27-gauge x 35-mm needle with an internal gauge of 0.215 mm) and 156 were XL Monoprotect. Incidence of deflection was observed in 49.1% of cases (170 needles) where 94 were standard needles and 76 XL Monoprotect. Needle torsion ranged from 0 degrees and 6 degrees. CONCLUSIONS: No significant differences were recorded in terms of deflection and internal gauge, operator, patient-extraction side, the anesthetic technique involved and the number of bone contacts during the procedure.

Comparative study of two needle models in terms of deflection duringinferior alveolar nerve block

Objectives: The purpose of this study is to determine the possible differences in deflection between two needlesof same length and external gauge but with different internal gauges during truncal block of the inferior alveolarnerve. The initial working hypothesis was that greater deflection may be expected with larger internal gaugeneedles.Study design: Four clinicians subjected 346 patients to inferior alveolar nerve block and infiltrating anesthesia ofthe buccal nerve trajectory for the surgical or conventional extraction of the lower third molar. A nonautoaspiratingsyringe system with 2 types of needle was used: a standard 27-gauge x 35-mm needle with an internal gaugeof 0.215 mm or an XL Monoprotect® 27-gauge x 35-mm needle with an internal gauge of 0.265 mm. The followinginformation was systematically recorded for each patient: needle type, gender, anesthetic technique (director indirect truncal block) and the number of bone contacts during the procedure, the patient-extraction side, thepractitioner performing the technique, and blood aspiration (either positive or negative).Results: 346 needles were used in total. 190 were standard needles (27-gauge x 35-mm needle with an internalgauge of 0.215 mm) and 156 were XL Monoprotect®. Incidence of deflection was observed in 49.1% of cases (170needles) where 94 were standard needles and 76 XL Monoprotect®. Needle torsion ranged from 0º and 6º.Conclusions: No significant differences were recorded in terms of deflection and internal gauge, operator, patientextractionside, the anesthetic technique involved and the number of bone contacts during the procedure (AU)

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Comparison of two needle models in terms of bevel deformation during truncal block of the inferior alveolar nerve.

OBJECTIVES: To evaluate the differences in terms of bevel deformation between two types of needle of the same length and external caliber, but with different internal diameters, during truncal block of the inferior alveolar nerve. STUDY DESIGN: Four operators performed truncal block of the inferior alveolar nerve and infiltrating anesthesia of the buccal nerve for the extraction of a lower third molar in 266 patients. The truncal block was carried out using a standard 27G x 35 mm needle with an internal caliber of 0.215 mm, or a 27G x 35 mm XL Monoprotect needle with an internal caliber of 0.265 mm. The infiltrating anesthesia was made with a Monoprotect or XL Monoprotect needle, both with a caliber of 30G and a length of 25 mm, but with different internal calibers (0.215 and 0.265 mm, respectively). The type of needle used, the anesthetic technique and the number of bone contacts was established during the procedure, the operator working side, the side of the tooth to be removed, the operator in charge of the intervention and the presence of bevel deformation after the anesthetic technique were collected for each patient. RESULTS: A statistically significant association was observed between bevel deformation and the operator performing the truncal block, while a statistically significant association (p use <0.05) was recorded between bevel deformation and the operator performing the infiltrating technique, the internal caliber of the needle and the number of bone contacts. CONCLUSIONS: There are no differences between the Monoprotect needles and the XL Monoprotect needles in terms of bevel deformation. Any such deformation can be attributable to physical -mechanical aspects such as the force with which the operator inserts the needle in the tissues- an aspect that in turn conditions the intensity of needle impact upon bone.

Comparison of two needle models in terms of bevel deformation during truncal block of the inferior alveolar nerve

Objetivos: Evaluar las posibles diferencias existentes en cuanto a la deformación del bisel de dos tipos de aguja de igual longitud y calibre externo, pero de distinto diámetro interno, durante el bloqueo troncal del nervio dentario inferior. Diseño del estudio: Cuatro operadores de similar formación quirúrgica realizaron el bloqueo troncal del nervio dentario inferior y la anestesia infiltrativa del nervio bucal para proceder a la extracción quirúrgica o convencional del tercer molar inferior en 266 pacientes. Para efectuar el bloqueo troncal se utilizó en todos los casos un sistema de jeringa no auto-aspirante (Uniject K(R); Hoechst AG, Frankfurt, Alemania) y dos tipos de aguja: una aguja Monoprotect® de 27G x 35 mm con un calibre interno de 0.215 mm (Sofic SA, Mazamet, Francia) o una aguja XL Monoprotect(R) de 27G x 35 mm con un calibre interno de 0.265 mm (Sofic SA, Mazamet, Francia). Para hacer la anestesia infiltrativa del nervio bucal se utilizó el mismo tipo de jeringa y otros dos tipos de aguja: la Monoprotecto(R) la XL Monoprotect(R), ambas con un calibre de 30G y 25 mm de longitud, diferenciándose en su calibre interno (0.215 y 0.265 mm, respectivamente) (Sofic SA, Mazamet, Francia). En cada paciente fue recopilada de forma sistemática la siguiente información: el tipo de aguja, la técnica anestésica utilizada (troncular directa o indirecta) y el número de veces que se había contactado con el hueso durante ésta, el lado de trabajo del operador, el lado del diente a extraer, el operador que hizo la intervención quirúrgica, así como la presencia o ausencia de deformación del bisel tras la técnica anestésica. Resultados: Para la técnica troncular, sólo se observó una asociación estadísticamente significativa entre la deformación de los biseles de las agujas y el operador que efectuó la técnica anestésica, mientras que para la técnica infiltrativa, se encontró una asociación estadísticamente significativa (p<0,05) entre la deformación de los biseles de las agujas y el operador que efectuó la técnica anestésica, el calibre interno de la aguja y el número de contactos óseos. Conclusiones: No existen diferencias entre las agujas Monoprotect(R) y las agujas XL Monoprotect(R) en cuanto a la deformación de su bisel, sino que la existencia de esta deformación obedece a aspectos físico-mecánicos como la fuerza con la que el operador introduce la aguja en los tejidos, que a su vez condicionará la intensidad del impacto de la aguja sobre el hueso

Objectives: To evaluate the differences in terms of bevel deformation between two types of needle of the same length and external caliber, but with different internal diameters, during truncal block of the inferior alveolar nerve. Study design: Four operators performed truncal block of the inferior alveolar nerve and infiltrating anesthesia of the buccal nerve for the extraction of a lower third molar in 266 patients. The truncal block was carried out using a standard 27G x 35 mm needle with an internal caliber of 0.215 mm, or a 27G x 35 mm XL Monoprotect® needle with an internal caliber of 0.265 mm. The infiltrating anesthesia was made with a Monoprotect® or XL Monoprotect® needle, both with a caliber of 30G and a length of 25 mm, but with different internal calibers (0.215 and 0.265 mm, respectively). The type of needle used, the anesthetic technique and the number of bone contacts was established during the procedure, the operator working side, the side of the tooth to be removed, the operator in charge of the intervention and the presence of bevel deformation after the anesthetic technique were collected for each patient. Results: A statistically significant association was observed between bevel deformation and the operator performing the truncal block, while a statistically significant association (p<0.05) was recorded between bevel deformation and the operator performing the infiltrating technique, the internal caliber of the needle and the number of bone contacts. Conclusions: There are no differences between the Monoprotect® needles and the XL Monoprotect® needles in terms of bevel deformation. Any such deformation can be attributable to physical-mechanical aspects such as the force with which the operator inserts the needle in the tissues – an aspect that in turn conditions the intensity of needle impact upon bone

Estudio comparativo de la eficacia anestésica de la Articaína al 4% respecto a la Lidocaína al 2% en el bloqueo troncal del nervio alveolar inferior durante la extracción quirúrgica de terceros molares inferiores / Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars

Objetivo: Valorar y comparar la eficacia anestésica de la Articaína al 4% respecto a la Lidocaína al 2%, ambas con una concentración de 1:100.000 de epinefrina en el bloqueo troncal del nervio alveolar inferior durante la extracción quirúrgica de terceros molares inferiores incluidos.Diseño del estudio: Se realizó un ensayo clínico aleatorio a doble ciego en una muestra de 30 pacientes programados para las extracciones quirúrgicas bilaterales de terceros molares inferiores simétricos en el Servicio de Cirugía Bucal del Máster de Cirugía e Implantología Bucal de la Universidad de Barcelona. Previo consentimiento del paciente, dos operadores efectuaron las intervenciones quirúrgicas de forma extemporánea, utilizando como anestésico local la Articaína al 4% o la Lidocaína al 2 % con la misma concentración de vasoconstrictor (epinefrina 1:100.000). Las variables estudiadas para cada anestésico fueron: tiempo de latencia (o de inicio del efecto anestésico), duración del efecto anestésico, cantidad de solución anestésica utilizada y la necesidad de reanestesiar la zona operatoria. Se utilizó una escala analógica visual para valorar la cantidad de dolor experimentado durante el acto quirúrgico y, así, evaluar subjetivamente la profundidad anestésica de las dos soluciones.Resultados: Se observaron diferencias estadísticamente significativas (p= .003) en cuanto a la duración del efecto anestésico,que fue mayor para la artcaína al 4% (220,8 minutos), respecto a la lidocaína al 2% (168,20 minutos). En las variables tiempo de latencia, cantidad de solución anestésica utilizada y necesidad de reanestesiar el campo operatorio se evidenciaron diferencias clínicas a favor de la articaína, aunque estas diferencias no fueron estadísticamente significativas.La valoración cualitativa de los anestésicos mediante la escala analógica visual mostró similitud en el dolor experimentado por los pacientes con ambos anestésicos.Conclusiones: De acuerdo con los resultados obtenidos se puede afirmar que la articaína al 4% muestra mejores característicasclínicas que la lidocaína al 2%, especialmente en cuanto al tiempo de latencia y duración del efecto anestésico. Sin embargo, no hubieron diferencias estadísticamente significativas que confirmen la superioridad de una solución respecto a la otra, al valorar la eficacia anestésica

Background: A comparative study is made of the anesthetic efficacy of 4% articaine versus 2% lidocaine, both with epinephrine 1:100,000, in truncal block of the inferior alveolar nerve during the surgical extraction of impacted lower third molars.Study design: A randomized double-blind clinical trial was conducted of 30 patients programmed for the bilateral surgical extraction of symmetrical lower third molars in the context of the Master of Oral Surgery and Implantology (University of Barcelona, Barcelona, Spain). Following the obtainment of informed consent, two operators performed surgery on an extemporaneous basis, using as local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor (epinephrine 1:100,000). The study variables for each anesthetic were: latency (time to action) and duration of anesthetic effect, the amount of anesthetic solution used, and the need of re-anesthetize the surgical zone. A visual analog scale was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions.Results: Statistically significant differences (p = 0.003) were observed in the mean duration of anesthetic effect (220.86 min. for 4% articaine vs. 168.20 min. for 2% lidocaine). Latency, the amount of anesthetic solution and the need to re-anesthetize the surgical field showed clinical differences in favor of articaine, though statistical significance was not reached. The pain scores indicated similar anesthetic efficacy with both solutions.Conclusions: The results obtained suggest that 4% articaine offers better clinical performance than 2% lidocaine, particularlyin terms of latency and duration of the anesthetic effect. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions

Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars.

BACKGROUND: A comparative study is made of the anesthetic efficacy of 4% articaine versus 2% lidocaine, both with epinephrine 1:100,000, in truncal block of the inferior alveolar nerve during the surgical extraction of impacted lower third molars. STUDY DESIGN: A randomized double-blind clinical trial was conducted of 30 patients programmed for the bilateral surgical extraction of symmetrical lower third molars in the context of the Master of Oral Surgery and Implantology (University of Barcelona, Barcelona, Spain). Following the obtainment of informed consent, two operators performed surgery on an extemporaneous basis, using as local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor (epinephrine 1:100,000). The study variables for each anesthetic were: latency (time to action) and duration of anesthetic effect, the amount of anesthetic solution used, and the need of re-anesthetize the surgical zone. A visual analog scale was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions. RESULTS: Statistically significant differences (p = 0.003) were observed in the mean duration of anesthetic effect (220.86 min. for 4% articaine vs. 168.20 min. for 2% lidocaine). Latency, the amount of anesthetic solution and the need to re-anesthetize the surgical field showed clinical differences in favor of articaine, though statistical significance was not reached. The pain scores indicated similar anesthetic efficacy with both solutions. CONCLUSIONS: The results obtained suggest that 4% articaine offers better clinical performance than 2% lidocaine, particularly in terms of latency and duration of the anesthetic effect. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions.

Day case oral surgery in pediatric patients during the year 2000 in the University of Barcelona Dental Clinic (Spain).

AIM: A study is made to show that most pediatric oral surgical interventions can be performed on a day case surgery or ambulatory basis, and to describe the activity of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain) in the year 2000. DESIGN: The study documents the surgical activity of the Units of Oral Surgery and Laser Surgery in pediatric patients, in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain). RESULTS: Of the 3187 operations carried out in our Service in this period, 489 involved patients under 18 years of age. The surgical removal of third molars was the most common intervention (55.6%), followed by other surgical or non-surgical tooth extractions (33.6%) and other interventions (10.6%) comprising fenestration of impacted canines or other teeth, frenectomies, the removal of mucoceles, and tooth relocations. Complications after surgical third molar extraction were recorded in 15.93% of cases, the most frequent problem being the pain and swelling (4.35% each) characteristic of postoperative inflammation. CONCLUSIONS: Our experience shows that day case oral surgery can be safely performed in pediatric patients, provided the required means and health care personnel resources are available.

Cirugía Bucal Ambulatoria en pacientes pediátricos. Casuística del año 2000 en la Clínica Odontológica de la Universidad de Barcelona / Day case oral surgery in pediatric patients during the year 2000 in the University of Barcelona

Objetivos: Este trabajo pretende demostrar que se pueden realizarla mayoría de las intervenciones quirúrgicas de la cavidadbucal en la población pediátrica en un medio ambulatorio, asícomo valorar y mostrar la actividad realizada en el Máster deCirugía e Implantología Bucal de la Facultad de Odontologíade la Universidad de Barcelona durante el año 2000.Diseño del estudio: Para la realización de este trabajo se ha contabilizadola actividad quirúrgica de las unidades de cirugía bucal ycirugía con láser en la población pediátrica en el Máster de Cirugíae Implantología Bucal de la Universidad de Barcelona.Resultados: De las 3187 intervenciones quirúrgicas realizadas ennuestro servicio, 489 fueron en pacientes menores de 18 años.La exodoncia quirúrgica de terceros molares inferiores fue lamás frecuente (55´6%), seguida de otras extracciones dentarias(33´6%), quirúrgicas o no, y del resto de intervenciones (10´6%)que incluyeron: fenestraciones de caninos u otros dientes incluidos,exéresis de frenillos, de mucoceles y reubicacionesdentarias. Se presentaron complicaciones tras la extracciónquirúrgica de los terceros molares en un 15Ê93% de los casos,siendo las más frecuentes el dolor (4´35%) y la tumefacción(4´35%), signos propios de la inflamación postoperatoria.Conclusiones: Nuestra experiencia muestra que la cirugía bucalambulatoria puede practicarse de forma segura en la poblaciónpediátrica siempre y cuando se disponga de los medios y delpersonal sanitario adecuados

Aim: A study is made to show that most pediatric oral surgicalinterventions can be performed on a day case surgery or ambulatorybasis, and to describe the activity of the Master of OralSurgery and Implantology (Barcelona University Dental School,Spain) in the year 2000.Design: The study documents the surgical activity of the Unitsof Oral Surgery and Laser Surgery in pediatric patients, in thecontext of the Master of Oral Surgery and Implantology (BarcelonaUniversity Dental School, Spain).Results: Of the 3187 operations carried out in our Service inthis period, 489 involved patients under 18 years of age. Thesurgical removal of third molars was the most common intervention(55.6%), followed by other surgical or non-surgical toothextractions (33.6%) and other interventions (10.6%) comprisingfenestration of impacted canines or other teeth, frenectomies,the removal of mucoceles, and tooth relocations. Complicationsafter surgical third molar extraction were recorded in 15.93% ofcases the most frequent problem being the pain and swelling(4.35% each) characteristic of postoperative inflammation.Conclusions: Our experience shows that day case oral surgerycan be safely performed in pediatric patients, provided the requiredmeans and health care personnel resources are available

Exéresis de las lesiones hiperplásicas de la cavidad bucal. Estudio retrospectivo de 128 casos / Removal of hyperplastic lesions of the oral cavity. A retrospective study of 128 cases

Objetivos: Este trabajo pretende, en base a nuestra experiencia, valorar y discutir las indicaciones, ventajas e inconvenientes de la exéresis de los épulis de la cavidad bucal con el láser de dióxido de carbono (CO2) respecto al láser de Erbio:YAG (Er:YAG), el láser de diodo y el bisturí frío.Material y método: Se ha realizado un estudio retrospectivo de un grupo de 120 pacientes en los que se extirparon 128 épulis con el láser de CO2, láser de Er:YAG, láser de diodo y bisturí frío. Se realizaron controles postoperatorios a los 7, 15 y 30 días para comprobar la cicatrización y la evolución de la herida y a los 3, 6 y 12 meses verificando si se había producido o no la recidiva de la lesión.Resultados: Según las características clínicas y etiopatogénicas de las lesiones extirpadas, se han formado dos grupos: las lesiones hiperplásicas gingivales (77 casos) y los épulis fisurados (51 casos). La localización más frecuente de las hiperplasias gingivales fue la mandíbula (51.9%). Se encontró que la hiperplasia fibrosa fue el diagnóstico histopatológico más frecuente con 49 casos (63.6%). El porcentaje de recidiva tras su extirpación fue del 9,1%, de los cuales 5 casos eran hiperplasias fibrosas. Sólo hubo un caso de lesión maligna que fue diagnosticada de carcinoma de células escamosas infiltrante.Por otro lado, de los 51 épulis fisurados tratados, el 58.8% se encontraban en el maxilar superior. Éstos fueron diagnosticados histológicamente como hiperplasias fibrosas, recidivando en el 19.6% de los casos.Conclusiones: Aunque las diferentes técnicas quirúrgicas utilizadas en la extirpación del épulis de la cavidad bucal son correctas, en nuestra opinión, el láser de CO2 es el tratamiento de elección, ya que ofrece ventajas tanto intra como postoperatorias. Por otro lado, es indispensable analizar histopatológicamente toda lesión de la cavidad bucal para establecer un diagnóstico de certeza

Aims: Based on our accumulated experience, the present study evaluates and discusses the indications, advantages and inconveniences of oral cavity epulis resection using the carbon dioxide laser (CO2) versus the Erbium:YAG laser (Er:YAG), diode laser and surgical scalpel.Material and methods: A retrospective study has been made of 120 patients involving the removal of 128 epulis lesions with the CO2 laser, Er:YAG laser, diode laser and surgical scalpel. Postoperative controls were carried out after 7, 15 and 30 days to evaluate healing and wound evolution, and after 3, 6 and 12 months to assess possible relapse.Results: Two groups were defined, based on the clinical and etiopathogenic characteristics of the excised lesions: gingival hyperplastic lesions (77 cases) and fibromatous hyperplasia (51 cases). The lower jaw was the most frequent location of gingival hyperplasia (51.9%). Fibrous hyperplasia was the most common histological diagnosis (49 cases; 63.6%). Percentage relapse following removal was 9.1%, of which 5 cases corresponded to fibrous hyperplasia. Only one malignancy was identified, corresponding to infiltrating squamous cell carcinoma.On the other hand, of the 51 treated cases of fibromatous hyperplasia, 58.8% were located in the upper jaw. These were histologically confirmed to be fibrous hyperplasia, with relapse in 19.6% of the cases.Conclusions: Although the different surgical techniques used for removal of epulis of the oral cavity are appropriate, we consider the CO2 laser to be the treatment of choice, since it offers a number of both intra- and postoperative advantages. On the other hand, all oral lesions require histological study to establish a firm diagnosis

Removal of hyperplastic lesions of the oral cavity. A retrospective study of 128 cases.

AIMS: Based on our accumulated experience, the present study evaluates and discusses the indications, advantages and inconveniences of oral cavity epulis resection using the carbon dioxide laser (CO2) versus the Erbium:YAG laser (Er:YAG), diode laser and surgical scalpel. MATERIAL AND METHODS: A retrospective study has been made of 120 patients involving the removal of 128 epulis lesions with the CO2 laser, Er:YAG laser, diode laser and surgical scalpel. Postoperative controls were carried out after 7, 15 and 30 days to evaluate healing and wound evolution, and after 3, 6 and 12 months to assess possible relapse. RESULTS: Two groups were defined, based on the clinical and etiopathogenic characteristics of the excised lesions: gingival hyperplastic lesions (77 cases) and fibromatous hyperplasia (51 cases). The lower jaw was the most frequent location of gingival hyperplasia (51.9%). Fibrous hyperplasia was the most common histological diagnosis (49 cases; 63.6%). Percentage relapse following removal was 9.1%, of which 5 cases corresponded to fibrous hyperplasia. Only one malignancy was identified, corresponding to infiltrating squamous cell carcinoma. On the other hand, of the 51 treated cases of fibromatous hyperplasia, 58.8% were located in the upper jaw. These were histologically confirmed to be fibrous hyperplasia, with relapse in 19.6% of the cases. CONCLUSIONS: Although the different surgical techniques used for removal of epulis of the oral cavity are appropriate, we consider the CO2 laser to be the treatment of choice, since it offers a number of both intra- and postoperative advantages. On the other hand, all oral lesions require histological study to establish a firm diagnosis.

Relación entre la hepatitis crónica vírica B y/o C y el liquen plano bucal / Association between B and/or C chronic viral hepatitis and oral lichen planus

Introducción: La hepatopatía crónica es una patología producida, principalmente, por la ingesta alcohólica y por la infección de los virus de la hepatitis B y/o C. En los últimos años se ha discutido ampliamente la posible asociación entre la hepatopatía crónica y el liquen plano bucal. Recientemente, se ha especulado que la asociación entre liquen plano bucal y la enfermedad hepática tiene una base de origen vírica. Material y método: El objetivo de este estudio transversal emparejado es conocer si existe relación entre las hepatitis víricas B y/o C crónicas y el liquen plano bucal. Para ello, se seleccionaron dos grupos de 100 individuos cada uno: un grupo de casos, formado por pacientes infectados con el virus de la hepatitis B y/o C y un grupo control, equiparado en edad y sexo al grupo de casos, cuyos pacientes no padecían hepatopatía alguna. Se exploró la cavidad bucal, principalmente para detectar lesiones de liquen plano en ambos grupos, aunque se registró cualquier otra alteración de la mucosa bucal. Resultados: No se encontró ningún paciente del grupo de casos con liquen plano bucal, siendo cuatro los individuos que padecían esta patología en el grupo control. Conclusiones: En nuestro estudio no se halló ninguna asociación entre la infección por el virus de la hepatitis B y/o C y el liquen plano bucal (AU)

Introduction: The chronic liver disease is a pathology produced, mainly, by the alcohol chronic abuse and by the hepatitis B and/or C virus infection. In the last years, it has been widely discussed the possible association between chronic liver disease and oral lichen planus. Recently, it has been suggested that the association between oral lichen planus and liver disease has a viral origin. Material and method: The objective of this transversal matched study is to know if there is a relationship between B and/or C viral chronic hepatitis and oral lichen planus. Two groups of 100 patients were selected: a case group with patients infected with hepatitis B and/or C virus, and a control group without liver disease matched in age and gender. Oral cavity was explored to detect lichen planus in both groups, but we registered other mucosal alterations. Results: We did not found any patient of the case group with oral lichen planus, but four patients with this disease in the control group. Conclusions: In our study we did not found any association between the infection with the hepatitis B and/or C virus and oral lichen planus (AU)

Association between B and/or C chronic viral hepatitis and oral lichen planus.

INTRODUCTION: The chronic liver disease is a pathology produced, mainly, by the alcohol chronic abuse and by the hepatitis B and/or C virus infection. In the last years, it has been widely discussed the possible association between chronic liver disease and oral lichen planus. Recently, it has been suggested that the association between oral lichen planus and liver disease has a viral origin. MATERIAL AND METHOD: The objective of this transversal matched study is to know if there is a relationship between B and/or C viral chronic hepatitis and oral lichen planus. Two groups of 100 patients were selected: a case group with patients. Infected with hepatitis B and/or C virus, and a control group without liver disease matched in age and gender. Oral cavity was explored to detect lichen planus in both groups, but we registered other mucosal alterations. RESULTS: We did not found any patient of the case group with oral lichen planus, but four patients with this disease in the control group. CONCLUSIONS: In our study we did not found any association between the infection with the hepatitis B and/or C virus and oral lichen planus.

Evaluation and comparison of 2 needle models in terms of blood aspiration during truncal block of the inferior alveolar nerve.

PURPOSE: We conducted a study to determine the possible differences in blood aspiration between 2 needles of the same length and external gauge but with different internal gauges during truncal block of the inferior alveolar nerve. The working hypothesis was that increased blood aspiration may be expected with larger internal gauge needles. MATERIALS AND METHODS: Four clinicians subjected 346 patients to inferior alveolar nerve block and infiltrating anesthesia of the buccal nerve trajectory for the surgical or conventional extraction of the lower third molar. A nonautoaspirating syringe system with 2 types of needle were used: a standard 27-gauge x 35-mm needle with an internal gauge of 0.215 mm and an XL Monoprotect (manufactured by Sofic, Mazamet, France, and distributed by Laboratorios Inibsa, Barcelona, Spain) 27-gauge x 35-mm needle with an internal gauge of 0.265 mm. The following information was recorded for each patient: needle type, gender, anesthetic technique (direct or indirect truncal block) and the number of bone contacts during the procedure, the patient-extraction side, the operator performing the technique, and blood aspiration (either positive or negative). RESULTS: No significant differences (P <.05) were observed on contrasting the blood aspiration positivity with the internal gauge of the needles. Likewise, no significant differences were seen on correlating aspiration to the anesthetic technique used, the number of bone contacts, the operator, or the patient-extraction side. Blood aspiration was observed in 8.7% of cases. CONCLUSIONS: No significant differences were recorded in terms of blood aspiration and internal gauge, operator, patient-extraction side, or the anesthetic technique involved. Consequently, our initial working hypothesis can be rejected, because no increased percentage of blood aspirations was observed for greater internal gauges.

Hepatitis Víricas. Implicaciones y consideraciones en la práctica odontológica / The viral hepatitis. Implications and considerations for the dental practice

Las hepatitis víricas, especialmente las causadas por los virus B y C representan para el odontólogo y su equipo de trabajo un riesgo ocupacional debido a la posible transmisión de partículas virales a través de la sangre u otros fluidos orgánicos. Esta entidad se define como un proceso inflamatorio del hígado, con la consecuente alteración de su función y puede ser causada por alguno de los siguientes virus hepatotrópicos: A, B, C, D, E y G. El objetivo de este artículo de revisión de la literatura es describir las principales manifestaciones de las hepatitis víricas, su evolución, tratamiento, además de presentar las principales consideraciones e implicaciones a tener en cuenta por el odontólogo a la hora de tratar este tipo de pacientes (AU)

El paciente con insuficiencia renal en la práctica odontológica / The patient with renal failure in dental practice

Los riñones son los responsables de funciones muy importantes dentro del organismo como la regulación del volumen -líquido- y del equilibrio acidobásico del plasma, la excreción de compuestos nitrogenados y la síntesis de eritropoyetina, hidroxicolecalciferol y renina. Las manifestaciones generales de la Insuficiencia Renal aparecen en los sistemas cardiovascular, gastrointestinal, neuromuscular, esquelético, hematológico y dermatológico. Por este motivo, es muy importante conocer sus principales características para prevenir y tratar correctamente los problemas que puedan surgir durante el tratamiento dental. Este artículo describe la fisiopatología, complicaciones y manifestaciones buca-les asociadas a esta condición así como las consideraciones y el tratamiento odontológicc del paciente con una Insuficiencia Renal (AU)